![]() ![]() The following tests are designed to determine the biological response of animals to elastomerics, plastics and other polymeric material with direct or indirect patient contact, or by the injection of specific extracts prepared from the material under test. It is essential to make available the specific surface area for extraction. When the surface area of the specimen cannot be determined, use 0.1 g of elastomer or 0.2 g of plastic or other material for every mL of extraction fluid. Also it is essential to exercise care in the preparation of the materials to be injected or instilled to prevent contamination with microorganisms and other foreign matter. Three tests are described. The Systemic Injection Test and the Intracutaneous Test are used for elastomeric materials, especially to elastomeric closures for which the appropriate Biological Reactivity Tests, In Vitro
![]() ![]() These three tests are applied to materials or medical devices, if there is a need for classification of plastics and other polymers based on in vivo biological reactivity testing.
For the purpose of this chapter, these definitions apply: the Sample is the specimen under test or an extract prepared from such a specimen. A Blank consists of the same quantity of the same extracting medium that is used for the extraction of the specimen under test, treated in the same manner as the extracting medium containing the specimen under test. A Negative Control* is a specimen that gives no reaction under the conditions of the test.
Classification of Plastics— Six Plastic Classes are defined (see Table 1). This classification is based on responses to a series of in vivo tests for which extracts, materials, and routes of administration are specified. These tests are directly related to the intended end-use of the plastic articles. The choice of extractants is representative of the vehicles in preparations with which the plastics are likely to be in contact. The Table 1 classification facilitates communication among suppliers, users, and manufacturers of plastics by summarizing the tests to be performed for containers for injections and medical devices if a need for classification exists.
Table 1. Classification of Plastics
With the exception of the Implantation Test, the procedures are based on the use of extracts that, depending on the heat resistance of the material, are prepared at one of three standard temperatures: 50
![]() ![]() ![]() ![]() ![]() ![]() ![]() Plastics may be classified as USP Plastic Classes I–VI only on the basis of the response criteria prescribed in Table 1.
This classification does not apply to plastics that are intended for use as containers for oral or topical products, or that may be used as an integral part of a drug formulation. Table 1 does not apply to natural elastomers, which are to be tested in Sodium Chloride Injection and vegetable oils only.
The Systemic Injection Test and the Intracutaneous Test are designed to determine the systemic and local, respectively, biological responses of animals to plastics and other polymers by the single-dose injection of specific extracts prepared from a Sample. The Implantation Test is designed to evaluate the reaction of living tissue to the plastic and other polymers by the implantation of the Sample itself into animal tissue. The proper preparation and placement of the specimens under aseptic conditions are important in the conduct of the Implantation Test.
These tests are designed for application to plastics and other polymers in the condition in which they are used. If the material is to be exposed to any cleansing or sterilization process prior to its end-use, then the tests are to be conducted on a Sample prepared from a specimen preconditioned by the same processing.
Factors such as material composition, processing and cleaning procedures, contacting media, inks, adhesives, absorption, adsorption and permeability of preservatives, and conditions of storage may also affect the suitability of a material for a specific use. Evaluation of such factors should be made by appropriate additional specific tests to determine the suitability of a material for its intended use.
Extracting Media—
sodium chloride injection
(see monograph). Use Sodium Chloride Injection containing 0.9% of NaCl.
1 in 20 solution of alcohol in
Sodium Chloride Injection.
polyethylene glycol 400
(see monograph).
vegetable oil—
Use freshly refined Sesame Oil (see monograph) or Cottonseed Oil (see monograph) or other suitable vegetable oils.
drug product vehicle
(where applicable).
water for injection
(see monograph).
note—The Sesame Oil or Cottonseed Oil or other suitable vegetable oil meets the following additional requirements. Obtain, if possible, freshly refined oil. Use three properly prepared animals and inject the oil intracutaneously in a dose of 0.2 mL into each of 10 sites per animal, and observe the animals at 24, 48, and 72 hours following injection. Rate the observations at each site on the numerical scale indicated in Table 2. For the 3 rabbits (30 injection sites), at any observation time, the average response for erythema is not greater than 0.5 and for edema is not greater than 1.0, and no site shows a tissue reaction larger than 10 mm in overall diameter. The residue of oil at the injection site should not be misinterpreted as edema. Edematous tissue blanches when gentle pressure is applied.
Table 2. Evaluation of Skin Reactions
Apparatus— The apparatus for the tests includes the following. ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() Preparation of Apparatus— Cleanse all glassware thoroughly with chromic acid cleansing mixture, or if necessary with hot nitric acid, followed by prolonged rinsing with water. Clean cutting utensils by an appropriate method (e.g., successive cleaning with acetone and methylene chloride) prior to use in subdividing a specimen. Clean all other equipment by thorough scrubbing with a suitable detergent and prolonged rinsing with water. Render containers and equipment used for extraction, and in transfer and administration of test material, sterile and dry by a suitable process. [note—If ethylene oxide is used as the sterilizing agent, allow adequate time for complete degassing.]
Procedure—
preparation of sample—
Both the Systemic Injection Test and the Intracutaneous Test may be performed using the same extract, if desired, or separate extracts may be made for each test. Select and subdivide into portions a Sample of the size indicated in Table 3. Remove particulate matter, such as lint and free particles, by treating each subdivided Sample or Negative Control as follows: place the Sample into a clean, glass-stoppered, 100-mL graduated cylinder of Type I glass, and add about 70 mL of Water for Injection. Agitate for about 30 seconds, and drain off the water, repeat this step, and dry those pieces prepared for the extraction with Vegetable Oil in an oven at a temperature not exceeding 50
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Table 3. Surface Area of Specimen To Be Used1
preparation of extracts—
Place a properly prepared Sample to be tested in an extraction container, and add 20 mL of the appropriate extracting medium. Repeat these directions for each extracting medium required for testing. Also prepare one 20-mL blank of each medium for parallel injections and comparisons. Extract by heating in an autoclave at 121
![]() ![]() ![]() Cool to about room temperature but not below 20
![]() ![]() ![]() Systemic Injection Test This test is designed to evaluate systemic responses to the extracts of materials under test following injection into mice.
Test Animal—
Use healthy, not previously used albino mice weighing between 17 and 23 g. For each test group use only mice of the same source. Allow water and food, commonly used for laboratory animals and of known composition, ad libitum.
Procedure—
[note—Agitate each extract vigorously prior to withdrawal of injection doses to ensure even distribution of the extracted matter. However, visible particulates should not be injected intravenously.] Inject each of the five mice in a test group with the Sample or the Blank as outlined in Table 4, except to dilute each g of the extract of the Sample prepared with Polyethylene Glycol 400, and the corresponding blank, with 4.1 volumes of Sodium Chloride Injection to obtain a solution having a concentration of about 200 mg of polyethylene glycol per mL.
Table 4. Injection Procedure—Systemic Injection Test
Observe the animals immediately after injection, again 4 hours after injection, and then at least at 24, 48, and 72 hours. If during the observation period none of the animals treated with the extract of the Sample shows a significantly greater biological reactivity than the animals treated with the Blank, the Sample meets the requirements of this test. If two or more mice die, or if abnormal behavior such as convulsions or prostration occurs in two or more mice, or if a body weight loss greater than 2 g occurs in three or more mice, the Sample does not meet the requirements of the test. If any animals treated with the Sample show only slight signs of biological reactivity, and not more than one animal shows gross symptoms of biological reactivity or dies, repeat the test using groups of 10 mice. On the repeat test, all 10 animals treated with the Sample show no significant biological reactivity above the Blank animals during the observation period.
Intracutaneous Test This test is designed to evaluate local responses to the extracts of materials under test following intracutaneous injection into rabbits.
Test Animal—
Select healthy, thin-skinned albino rabbits whose fur can be clipped closely and whose skin is free from mechanical irritation or trauma. In handling the animals, avoid touching the injection sites during observation periods, except to discriminate between edema and an oil residue. [note—Rabbits previously used in unrelated tests, such as the Pyrogen Test
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Procedure—
[note—Agitate each extract vigorously prior to withdrawal of injection doses to ensure even distribution of the extracted matter.] On the day of the test, closely clip the fur on the animal's back on both sides of the spinal column over a sufficiently large test area. Avoid mechanical irritation and trauma. Remove loose hair by means of vacuum. If necessary, swab the skin lightly with diluted alcohol, and dry the skin prior to injection. More than one extract from a given material can be used per rabbit, if you have determined that the test results will not be affected. For each Sample use two animals and inject each intracutaneously, using one side of the animal for the Sample and the other side for the Blank, as outlined in Table 5. [note—Dilute each g of the extract of the Sample prepared with Polyethylene Glycol 400, and the corresponding Blank, with 7.4 volumes of Sodium Chloride Injection to obtain a solution having a concentration of about 120 mg of polyethylene glycol per mL.]
Table 5. Intracutaneous Test
Examine injection sites for evidence of any tissue reaction such as erythema, edema, and necrosis. Swab the skin lightly, if necessary, with diluted alcohol to facilitate reading of injection sites. Observe all animals at 24, 48, and 72 hours after injection. Rate the observations on a numerical scale for the extract of the Sample and for the Blank, using Table 2. Reclip the fur as necessary during the observation period. The average erythema and edema scores for Sample and Blank sites are determined at every scoring interval (24, 48, and 72 hours) for each rabbit. After the 72 hour scoring, all erythema scores plus edema scores are totalled separately for each Sample and Blank. Divide each of the totals by 12 (2 animals × 3 scoring periods × 2 scoring categories) to determine the overall mean score for each Sample versus each corresponding Blank. The requirements of the test are met if the difference between the Sample and the Blank mean score is 1.0 or less. If at any observation period the average reaction to the Sample is questionably greater than the average reaction to the Blank, repeat the test using three additional rabbits. The requirements of the test are met if the difference between the Sample and the Blank mean score is 1.0 or less.
Implantation Test The implantation test is designed for the evaluation of plastic materials and other polymeric materials in direct contact with living tissue. Of importance are the proper preparation of the implant strips and their proper implantation under aseptic conditions. Prepare for implantation 8 strips of the Sample and 4 strips of USP High-Density Polyethylene RS. Each strip should measure not less than 10 × 1 mm. The edges of the strips should be as smooth as possible to avoid additional mechanical trauma upon implantation. Strips of the specified minimum size are implanted by means of a hypodermic needle (15- to 19-gauge) with intravenous point and a sterile trocar. Use either presterilized needles into which the sterile plastic strips are aseptically inserted, or insert each clean strip into a needle, the cannula and hub of which are protected with an appropriate cover, and then subjected to the appropriate sterilization procedure. [note—Allow for proper degassing if agents such as ethylene oxide are used.]
Test Animal—
Select healthy, adult rabbits weighing not less than 2.5 kg, and whose paravertebral muscles are sufficiently large in size to allow for implantation of the test strips. Do not use any muscular tissue other than the paravertebral site. The animals must be anesthetized with a commonly used anesthetic agent to a degree deep enough to prevent muscular movements, such as twitching.
Procedure—
Perform the test in a clean area. On the day of the test or up to 20 hours before testing, clip the fur of the animals on both sides of the spinal column. Remove loose hair by means of vacuum. Swab the skin lightly with diluted alcohol and dry the skin prior to injection.
Implant four strips of the Sample into the paravertebral muscle on one side of the spine of each of two rabbits, 2.5 to 5 cm from the midline and parallel to the spinal column, and about 2.5 cm apart from each other. In a similar fashion implant two strips of USP High-Density Polyethylene RS. in the opposite muscle of each animal. Insert a sterile stylet into the needle to hold the implant strip in the tissue while withdrawing the needle. If excessive bleeding is observed after implantation of a strip, place a duplicate strip at another site.
Keep the animals for a period of not less than 120 hours, and sacrifice them at the end of the observation period by administering an overdose of an anesthetic agent or other suitable agents. Allow sufficient time to elapse for the tissue to be cut without bleeding. Examine macroscopically the area of the tissue surrounding the center portion of each implant strip. Use a magnifying lens and auxiliary light source. Observe the Sample and Control implant sites for hemorrhage, necrosis, discolorations, and infections, and record the observations. Measure encapsulation, if present, by recording the width of the capsule (from the periphery of the space occupied by the implant Control or Sample to the periphery of the capsule) rounded to the nearest 0.1 mm. Score encapsulation according to Table 6.
Table 6. Evaluation of Encapsulation in the Implantation Test
Calculate the differences between average scores for the Sample and Control sites. The requirements of the test are met if the difference does not exceed 1.0, or if the difference between the Sample and Control mean scores for more than one of the four implant sites does not exceed 1 for any implanted animal.
SAFETY TESTS—BIOLOGICALS The safety test set forth here is intended to detect in an article any unexpected, unacceptable biological reactivity. This in vivo test is provided for the safety assessment of biologics (see Biologics
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Safety Test
Select five healthy mice not previously used for testing, weighing between 17 and 23 g, unless otherwise directed in the individual monograph or elsewhere in this chapter, and maintained on an adequate balanced diet. Prepare a test solution as directed in the individual monograph. Unless otherwise directed in the individual monograph or elsewhere in this chapter, inject intravenously a dose of 0.5 mL of the test solution into each of the mice, using a 26-gauge needle of suitable length, or of the length specified below as applicable. Observe the animals over the 48 hours following the injection. If, at the end of 48 hours, all of the animals survive and not more than one of the animals shows outward symptoms of a reaction not normally expected of the level of toxicity related to the article, the requirements of this test are met. If one or more animals die or if more than one of the animals shows signs of abnormal or untoward toxicity of the article under test, repeat the test using at least another 10 mice similar to those used in the initial test, but weighing 20 ± 1 g. In either case, if all of the animals survive for 48 hours and show no symptoms of a reaction indicative of an abnormal or undue level of toxicity of the article, the requirements of the test are met.
For biologics, perform the test according to the procedures prescribed in the Federal Regulations (see Biologics
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*
USP High-Density Polyethylene RS.
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